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Mesa County considers starting own clinic

In an effort to offer Mesa County employees more health care services for less money, county leaders are considering starting up their own health care clinic.

The issue, which is slated for a vote by county commissioners Monday, was debated during an 11th-hour meeting Friday morning. County leaders, local physicians and representatives from local health care agencies attended, and health care professionals strongly opposed the idea. They said they had heard little mention about the plan before Friday.

According to county figures, without any changes in the local economy, county employees would see a 40 percent increase in their health insurance premiums next year, or the county would drastically have to slash benefits. Mesa County is facing a $950,000 increase, or 15 percent increase, to its health care costs, which are extended to about 1,300 employees and family members enrolled in the optional plan.

Mesa County is self-insured, meaning it pays all claims. Those claims are processed through the CNIC Health Solutions, a third-party administrator run by Rocky Mountain Health Plans.

County officials say they want to contract with local physicians to run the clinic. And, county employees enrolled in the plan could choose to go to the clinic for primary care services, or continue to see their primary care doctor. However, there would be a financial incentive for county employees to go to the clinic. For example, a county clinic visit might be $60 if a primary care doctor visit costs $100.

Claims would still be processed by CNIC, and estimates show the county could save $370,000, a 6 percent savings, in its first year of operation in 2011. Those savings are expected to continue each year, and the savings could increase if the visits help in preventive care, Assistant Mesa County Administrator Stefani Conley said.

“The county doesn’t have the resources to absorb the increases,” she said. “If we increase the premiums or slash the benefits, that doesn’t do anyone good, because (employees) don’t get care. We really are trying to protect that primary-care-first model.”

Conley said she has heard from officials in other counties that have instated county clinics, and it is saving them even more funds than anticipated. El Paso County in Colorado Springs has converted to the county clinic model, and the counties of Weld and Douglas are considering the switch, Mesa County Administrator Jon Peacock said.

But the proposal is less than palatable for about a half-dozen physicians who attended Friday’s meeting.

Complaints include that county employees will use the Grand Valley’s primary care doctors for more complicated, chronic care and bypass them for the wellness visits, a portion of the doctors’ practice in which they earn money. Physicians take a financial hit to take on Medicare and Medicaid patients because of paltry reimbursement rates from the government. Patients who pay for services through private insurances help bridge those gaps.

Doctors said patients would lose their relationships with current primary care doctors, although primary care doctors would have to pick up the slack to care for patients after hours or when a patient needed to be admitted to a hospital.

Inevitably, some physicians said, the scenario may have more patients using emergency rooms, a prospect that has a trickle-down effect of increasing the overall cost of health care coverage.

Doctors also questioned whether the proposed model would save funds. Collaboration and funding from local health care agencies and grants have created the online medical database, Quality Health Network. That database gives medical professionals a snapshot of a patient’s medical history. It can save health care costs by eliminating the potential for patients to be overtreated with unnecessary tests or be overprescribed medication.

“Let us look over the data and don’t vote on it Monday,” said Dr. Patrice Whistler, a local pediatrician. “Has this been looked at in this community that has the lowest hospital rates in the country?”